KENDALL IMPLANT AND ORAL SURGERY


Address: 109 Falls Ct Ste 700, Boerne, TX 78006-2984
Phone: 8303312007

KENDALL IMPLANT AND ORAL SURGERY (NPI# 1437779691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1437779691
Entity Type Organization
Organization Name KENDALL IMPLANT AND ORAL SURGERY
Practice Address 109 Falls Ct Ste 700
Boerne
TX 78006-2984
Practice Telephone 8303312007
Practice Fax Number 8303312009
Mailing Telephone 8303312007
Mailing Fax Number 8303312009
Enumeration Date 2020-04-17
Last Update Date 2020-04-17
Authorized Official Name CHARLES LEE CLARK (OWNER)
Authorized Official Telephone 8303312007
Authorized Official Credential DDS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
Dental Providers

Office Location

Street Address 109 FALLS CT STE 700
City BOERNE
State TX
Zip Code 78006-2984

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Taxonomy Information

Taxonomy Code 1223S0112X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

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Competitor

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City BOERNE
Zip Code 78006

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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